A BIPARTISAN bill that proposes to create a Health Network Program “as an integrated service of the Commonwealth Healthcare Corp.” was amended by the Senate to include a provision that would write off outstanding balances of medical referral promissory notes.
The Senate unanimously passed House Bill 22-77 as amended on Dec. 28, 2022. It now returns to the House of Representatives for action.
Introduced by Rep. Tina Sablan, House Bill 22-77 aims to provide for the orderly transition of medical referral services administration and operations to CHCC.
According to the House leadership, the bill “protects CHCC from incurring outstanding debts and liabilities of the former medical referral office. The bill further clarifies that outstanding promissory notes shall remain a receivable of the central government and not the responsibility of CHCC.”
Senate President Jude U. Hofschneider introduced the following amendment to write off outstanding balances of medical referral promissory notes:
“Notwithstanding any law to the contrary, the CNMI government shall write off all principal and interest due on all the outstanding promissory notes executed by the Off-Island Medical Referral Program and patients on or before the effective date of this Act. The Department of Finance shall issue a notice of the promissory note write-off to patients or their personal representatives within 180 days of the effective date of this Act.”
During the Senate deliberation, Sen. Teresita A. Santos said it is necessary to establish the Health Network Program within CHCC so that “providers are recognized, and partners and third-party payers — such as the CNMI Medicaid Agency — are optimally engaged to cover the costs of services.”
Sen. Edith Deleon Guerrero said she appreciated the proposed amendment. “It’s quite clear that there’s no standing statute that allows for any execution of promissory notes, but additionally, in my personal belief that individuals, our citizens of the Commonwealth are indigent and therefore referred under the medical referral program, and to be saddled with such a huge amount of liability that they themselves cannot afford to pay back to take care of their health, is more the reason why I will be in support of this amendment to remove the liability that is placed on the family as a burden, and most especially the patient,” she said.
For his part, Hofschneider said the CNMI should “partner with facilities or providers that qualify for Medicare or Medicaid…so that if we do have to ‘front-load’ it, there is that reimbursement mechanism that we can deploy.”
He added, “Everybody knows that we’re always going to be in need of healthcare outside our hospital.”
One of the key provisions of the House bill states that the Health Network Program should be operated “in a manner that does not exceed the CNMI general fund appropriation for HNP. If appropriated funding for the Health Network Program is exhausted prior to the end of the fiscal year, the CHCC shall submit a request to the Governor and the Legislature for supplemental appropriations.”
“What happens to medical referral patients if the funding runs out and there’s still no supplemental appropriation?” asked a resident who declined to be identified.
One of the “chronic” problems with the medical referral program was the lack of funding. The governor ended up reprogramming funds to pay for medical referrals.
The House is scheduled to convene for a session at 10 a.m. today, Thursday, Jan. 5, in the House chamber.
Jude Hofschneider
